Author: Jordan N Kohn#1,2, Judith D Lobo#3, Emily A Troyer3, Gavrila Ang4, Kathleen L Wilson4, Amanda L Walker4, Chad Spoon4, Christopher Pruitt4, Lize Tibiriçá5,3, Meredith A Pung4, Laura S Redwine6, Suzi Hong4,3
Affiliation:
1 Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, 92093, US. jokohn@health.ucsd.edu.
2 Sam and Rose Stein Institute for Research On Aging, University of California San Diego, La Jolla, CA, 92093, US. jokohn@health.ucsd.edu.
3 Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, US.
4 Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, 92093, US.
5 Sam and Rose Stein Institute for Research On Aging, University of California San Diego, La Jolla, CA, 92093, US.
6 Family Medicine and Community Health, Osher Center for Integrative Health, University of Miami, Miller School of Medicine, Miami, FL, 33136, US.
Conference/Journal: Aging Clin Exp Res
Date published: 2023 Jul 17
Other:
Special Notes: doi: 10.1007/s40520-023-02504-w. , Word Count: 276
Background:
Frailty is associated with poor outcomes among older adults with hypertension and complicates its pharmacological management. Here, we assessed whether 12-weeks of instructor-guided, group Tai Chi (TC) practice improved frailty relative to Healthy Aging Practice-centered Education (HAP-E) classes in older adults with hypertension.
Methods:
Secondary analysis of a randomized controlled trial in San Diego County, USA, of 167 community-dwelling individuals aged ≥ 60 yrs (70% female; 72.1 ± 7.5 yrs), defined as non-frail (66%) or frail (34%) based on 53-item deficit accumulation frailty index (FI). Linear mixed-effects models were used to assess pre-to-post intervention differences in FI and logistic regression to explore differential odds of clinically meaningful FI change.
Results:
One hundred thirty-one participants completed post-intervention assessments. Frailty decreased pre-to-post intervention in the TC (ΔFI = - 0.016, d = - 0.39, - 0.75 to - 0.03), but not the HAP-E arm (ΔFI = - 0.009, d = - 0.13, - 0.52-0.27), despite no significant group differences between the TC and HAP-E arms (d = - 0.11, - 0.46-0.23). Furthermore, greater odds of improved FI were observed for frail participants in the TC (OR = 3.84, 1.14-14.9), but not the HAP-E (OR = 1.34, 0.39-4.56) arm. Subgroup analysis indicated treatment effects in TC were attributed to frail participants (frail: ΔFI = - 0.035, d = - 0.68, -1.26 to - 0.08; non-frail: ΔFI = - 0.005, d = - 0.19, - 0.59-0.22), which was not the case in the HAP-E arm (frail: ΔFI = - 0.017, d = - 0.23, - 0.81-0.35; non-frail: ΔFI = - 0.003, d = - 0.07, - 0.47-0.33). Frail participants were no more likely to drop-out of the study than non-frail (71% vs. 69% retained).
Conclusions:
Twelve weeks of twice-weekly guided TC practice was well-tolerated, associated with decreases in frailty, and increased odds of clinically meaningful FI improvement at post-intervention.
Keywords: Frailty; Hypertension; Randomized controlled trial; Tai Chi.
PMID: 37458963 DOI: 10.1007/s40520-023-02504-w
